what is there to be afraid of?

JB2007, ASN, RN · Oct 6, 2008

All I can say is document very well. If it is not documented it was not done. We live in a sue happy world and all that is going to save your butt in court is you documentation. There is nothing you can do to keep all of you pts and families happy, so CYA with your documentation. Sad to say, but this is what our world is coming to.

RNperdiem, RN · Oct 6, 2008

Listen to your instincts.

With a little experience you will have a sense of which families, patients and situations can land you in trouble.

Some people are angry before you even greet them with "Good morning ,my name in Jane, I will be your nurse today."

There are families with notebooks who write everything down, take pictures and have requested certain nurses not take care of their loved one. They will watch every move you make.

When you sense trouble, be extra careful about what you say and do. Document more extensively than usual.

Relatively few nurses will end up in court. It is difficult to prove real harm done, and there is not much money anyway in targeting nurses.

More likely, trouble can put your job at risk if management is unsupportive.

Vito Andolini · Oct 6, 2008

Always follow policy.

The less said, the better, especially if you can't say something nice.

No lies. You won't remember all of them, so don't tell any.

Be nice.

Do not let coworkers misbehave, that is, no excessive smoke breaks, no hiding out, no evading and avoiding work, no abuse or neglect of patients. If you do, you will have opened the door to them doing it more. Give them an inch and they'll take a mile, kind of thing. Some are honorable and would not take advantage to begin with but some aer less than honorable.

Your boss and your employer are not your friends, most likely. They are the enemy. You are only worth something to them if you are doing what they want, that is, the mandatory OT, the too-heavy assignments, donating your break times to the job, clocking out and then charting and otherwise finishing up your work. They probably won't be there for you when you need time off or some other reasonable accommodation or if you make an error. Therefore, give to your job only that which you can genuinely give without resentment. I could be wrong. Maybe your job is heaven on earth.

Daytonite, BSN, RN · Oct 6, 2008

attend some legal ceu classes. people can pretty much only collect money from you in a lawsuit if you have damaged them in some way through your negligence. to have done that means you either didn't follow facility rules, nursing law rules of your state or good principles of safety which is pretty much horse sense. then, it's a matter of charting what you did or didn't do. when an incident happens, the culprits are usually found. the best thing you can do for yourself is know and follow your facility policies. i have always said that everyone should be sent through the sit down part of orientation about 6 months or a year after they have been working to clear up questions that have come up during work.

when i started studying health information management (medical records) i was surprised to find that the nursing documentation was rarely looked at. it was the doctor's documentation that was primarily focused on. the nursing documentation only became important, and rarely at that, when something in the physician documentation was very unclear.

Neveranurseagain, RN · Oct 6, 2008

Listen to the family. If they are concerned about the pt. and "are bugging you," don't just blow them off and get angry with them. Most of the time families will tell you, "I just knew he was not acting right," or "I told you so!" after a major incident that could have been avoided. If you are frustrated with them, have another RN reassess them. The Rapid Pt. Assessment Team should be available to families soon too, with the new JACHO requirement.

I write this after I battled with staff about my 47 year old husband after I felt they were missing his declining condition. All they did was shut me off and ignore him. And he died, 4 yrs ago yesterday. :cry: Now, due to the malpractice settlement I received, I can stay home with the kids...but I would much rather have my husband, and I'm sure the RN's would much rather have their licenses.

Mulan · Oct 6, 2008

Listen to the family. If they are concerned about the pt. and "are bugging you," don't just blow them off and get angry with them. Most of the time families will tell you, "I just knew he was not acting right," or "I told you so!" after a major incident that could have been avoided. If you are frustrated with them, have another RN reassess them. The Rapid Pt. Assessment Team should be available to families soon too, with the new JACHO requirement.
I write this after I battled with staff about my 47 year old husband after I felt they were missing his declining condition. All they did was shut me off and ignore him. And he died, 4 yrs ago yesterday. Now, due to the malpractice settlement I received, I can stay home with the kids...but I would much rather have my husband, and I'm sure the RN's would much rather have their licenses.

I'm sorry for your loss.

Looking back, hindsight being 20/20, what would/could have been done differently (other than the nurses listening)?

Neveranurseagain, RN · Oct 6, 2008

I wish I would have called 911 from the ER is my biggest regret... I should have never trusted the MD's and RN's and listened to my gut and had him transferred to another hospital. But if you can't trust health care workers, who can you trust?

I also feel if I had access to a Rapid Response Team who would of taken a fresh look of him he would still be alive.

I also feel if I would not of had Kaiser, he would be alive. They will do anything to retain/defend an MD who has a history of poor pt. care.

And the scary thing is that I still have Kaiser. It's Kaiser or no health insurance at all. I'm afraid to see them and they are afraid to see me!

angelstrings · Oct 6, 2008

JB,

One of the first things I intend to do is find a charting class when I am hired. Thank you for the response.

dny

angelstrings · Oct 6, 2008

Vito,

When I am hired will they show me their policies? Are the policies just for the area where I work, or are they hospital-wide policies? How long do they usually take to read and internalize?

Thanks,

dny

angelstrings · Oct 6, 2008

awsmom,

I too am sorry about your loss. If you have the energy to share it, and the time, I would like to hear exactly what those nurses were doing when the blew you off. I'm trying to lean what "not" to do.

I am about to graduate, and I am terrified of making a mistake. Especially being new and not always able to anticipate.

Isn't that the biggest part of any job, anticipation? Then to act upon what one knows is needed.

If you ever care the share your story, I would like to listen.

dny

Neveranurseagain, RN · Oct 6, 2008

As part of my settlement, I had to sign a confidentiality statement and am unable to discuss the events leading to his death. It is another example of the medical field "sweeping under the rug" medical errors/incidents that should be discussed under a "no fault" system. It is important that everyone in the healthcare system to learn from these events so they are not repeated. We are caring for the most precious things in the world--people. Other businesses publish error/incidents so employees and others can learn from their mistakes, except the healthcare field. Yet it is the patient and their families, and the healthcare workers who know they caused the error, that end up suffering from this system.

You are a pt. advocate. Always do what is in the best interest of your pt., even if it angers your coworkers.

Read some of my first several posts when you have time. Don't get on autopilot and common sense goes along ways. If you were taught a condition has a red flag, believe it, even if the pt. "looks good." And remember healthy people compensate, compensate, compensate, then can crash rather quickly.